Treatment outcomes of brain metastasis from primary renal cell carcinoma in United States: A National Cancer Database analysis.

Authors

null

Vivek Podder

Miami Cancer Institute, Baptist Health South Florida, Miami, FL

Vivek Podder , Mohammad Arfat Ganiyani , Shahzaib Ahmad , Shreyas S Bellur , Muhammad Abbas Khokhar , Fathima Shehnaz Ayoobkhan , Manas Pustake , Diya K Jayram , Ahmad Ozair , Tulika Ranjan , Rohan Garje , Manmeet Singh Ahluwalia

Organizations

Miami Cancer Institute, Baptist Health South Florida, Miami, FL, King Edward Medical University, Lahore, Pakistan, Trinity Health Oakland Hospital/Wayne State University, Pontiac, MI, Grant Government Medical College, Mumbai, India, John Hopkins University, Baltimore, MD, Miami Cancer Insitute, Baptist Health South Florida, Miami, FL

Research Funding

No funding sources reported

Background: The advent of stereotactic radiosurgery (SRS) in treatment of brain metastasis (BM) has improved both clinical outcomes and survival in patients with BM. Recent studies suggest that immunotherapy presents a promising potential in the treatment of patients with BM. However, data regarding the effectiveness of combining SRS with immunotherapy for BM in metastatic renal cell carcinoma (RCC) remain largely unknown. We aim to delineate the impact of various treatment therapies including combination therapy for treatment of RCCBM. Methods: We queried the National Cancer Database (NCDB) to include patients with BM from mRCC from 2004 to 2020. We divided the patients into groups based on the treatment they received. Resultantly, 5 different treatment groups i.e., WRBT± immunotherapy, SRS± immunotherapy and immunotherapy alone were identified. We excluded patients with unknown treatment status. We analyzed survival outcomes using the Kaplan-Meier analysis and compared the effect of treatment modalities on survival with the log-rank test. Results: The NCDB yielded 6,446 patients diagnosed with BM from mRCC. In eligible cases, the median age was 63 years (range: 19-90+ years), 69.2% were male, 86.8% were White, 7.9% were Black, 41.9% had Medicare as primary payor, 27.7% had annual income >$74,063, 79.3% belonged from metropolitan areas, 39.6% were treated at academic/research program, 68.3% had Charlson-Deyo score of 0, 44.6% had an unknown grade of the primary RCC. 1,705 (43.44%) patients who were given WBRT had a median overall survival (OS) of 5.65 months, 427 (10.88%) patients were treated with SRT + immunotherapy had an OS of 19.0 months, 987 (25.15%) patients who underwent SRT only had an OS of 9.7 months, 431 (10.98%) patients who received immunotherapy only showed an OS of 12.9 months, and 375 (9.55%) patients who underwent WBRT + immunotherapy had an OS of 12.78 months (log-rank p <0.001). Conclusions: This national database analysis reveals that the combination of SRS with immunotherapy significantly increases the OS in RCCBM compared to immunotherapy, WBRT, or combination of WRBT and immunotherapy. Further prospective studies are warranted to confirm these findings.

Difference in patient characteristics among treatment approaches.

CharacteristicsWBRT AloneSRS + ImmunotherapySRSImmunotherapy OnlyWBRT + ImmunotherapyP value
Age
≤64
996280533271231<0.0001
≥65754150477164145
Facility
Academic
6411834571661500.0002
Others1109247533269226
Insurance
Private
6872173952061550.0001
Medicaid182441-54542
Medicare711148440158154
Race
White
15162918893783260.4312
Black14120663729

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2024 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary Cancer—Kidney and Bladder

Track

Genitourinary Cancer—Kidney and Bladder

Sub Track

Kidney Cancer

Citation

J Clin Oncol 42, 2024 (suppl 16; abstr 4561)

DOI

10.1200/JCO.2024.42.16_suppl.4561

Abstract #

4561

Poster Bd #

256

Abstract Disclosures